[Raine08]

Hello,

I am looking to switch to hospice nursing. I am looking for a company that offers a good orientation and support for new nurses entering the field. With so many different companies out there, I dont know which ones are good and which ones I should stay away from. I live in PA/DE area. Some of the companies around here are VITAS, Compassionate Care Hospice, ACTS, Heartland Home Health & Hospice, VISTA, and of course there are those affiliated with the hospital and VNA. Anyone wish to comment???
What should I look for and what should I stay away from?

[Diahni]

Originally Posted by Raine08

Hello,

I am looking to switch to hospice nursing. I am looking for a company that offers a good orientation and support for new nurses entering the field. With so many different companies out there, I dont know which ones are good and which ones I should stay away from. I live in PA/DE area. Some of the companies around here are VITAS, Compassionate Care Hospice, ACTS, Heartland Home Health & Hospice, VISTA, and of course there are those affiliated with the hospital and VNA. Anyone wish to comment???
What should I look for and what should I stay away from?

Hi Raine,
I'm in your boat, on the other side of the US - One way for you to research this is good ole Google - if somebody has a beef with a company, be they consumer or worker, it will, no doubt, show up on the internet. No more secrets in the digital age! I have a question - do you think hospice nursing requires more or less the same qualities that direct care requires, or are there also some unique abilities and skills required of hospice nurses? I am exploring this, as I'm considering the field.
Diahni

[hospicenurse]

Look into Delaware Hospice - they are nonprofit and have an excellent reputation.

hn

[momtotwo]

Gotta give a thumbs up for Compassionate Care!

[rnboysmom]

A good place to start is by making a list of the things you think you could actually give to the hospice profession---and be honest. Can you work late if needed, can you get up in the middle of the night to go see patients if you are on call? Do you have small children that you would have to drag out to a sitter in the middle of the night if the company requires on-call?
Do you have a flexible schedule? Are you willing to work your day until it is completely finished? Do you adapt easily to change? (the age old saying.....being a hospice nurse is waking up each day with the knowledge that your schedule IS GOING to change). Do you have a good faith base? A good support network? Excellent clinical skills?
Ask questions like:
1. What is the average caseload for a case manager ( DO NOT be fooled by a company report of "nursing" to patient ratios as some companies report their supervisory staff in the ratios) Find out what the average is for daily visits (4 is average). Ask if you can interview a current case manager. ( a good company is usually proud of the staff they have built and their sense of "team" and they are okay with you talking to staff.)
2 What type of training will I get? How long before I get a full-caseload? Will I have a mentor? What types of ongoing training does the company provide to it's case managers?
3. What types of program is there for stress relief? Does the company allow respite time after difficult cases? Does the company allot paperwork time into nursing schedules?
4. How much on-call would I be required to do in a typical month. What does the company do if they lose staff and more on-call is required. What is the on-call compensation? Does the hospice have a designated on-call staff--what happens if this changes? Does the management team assist with on-call--how available are they if I need hands-on help (DURING THE DAY AND IN THE MIDDLE OF THE NIGHT).
5. Is the company on paper charting or computer charting (this really does make a difference if you have come from one setting or the other--I know some seasoned nurses who will absolutely not do computer charting)
6. Ask about benefits BEWARE of the company that provides excessive time or too little time, hospitals in the area usually have a competitive vacation package---how does the hospice compare? A ton of PTO may seem like a great option up front (I can say this as my first job offered 30 PTO days a year--problem was, you either were so short staffed that you couldn't go on vacation or you were using your PTO time to take off to sleep after grueling nites of on-call and being out all night--when you couldn't get any time for PTO they paid you out at half time). An important question---what type of personal bereavement do they offer their employees in times of personal loss (one of my nurses was actually fired from one of the older national companies for not having the foresight to predict that her husband would die suddenly in December and she hadn't saved any PTO time for the event!!! --even though they were required to use their PTO time by the end of the year and didn't allow any PTO time during the holiday season---DUH-everyone had used all of their time as required)

This is long---and I apologize for that, but the problem is, there are some very good companies and some very very bad companies--sometimes it is just bad management in the local company but the nationwide company is okay.
Hospice nursing is an art, and a calling and we all deserve to be treated with dignity and respect---choose your company carefully.
Good Luck

[Kabin]

Maybe it's already been mentioned but it might be good to look at nonprofit hospice companies. They tend to be less focused on money and have more services for the patient/family.

[Hal_Dol]

Hello All:
I like VITAS very much.
Have worked for them 2 years as an LPN that does crisis-care shifts of 13 hours each night. All the staff I've worked with are dedicated (no back-stabbing), compassionate, well-trained.
Allan
PS:I'm 62 y.o. so the ONLY problem I've had is that at 4am my body asks when I'm going to get a day job.

[Hospice Nurse LPN]

Originally Posted by Kabin

Maybe it's already been mentioned but it might be good to look at nonprofit hospice companies. They tend to be less focused on money and have more services for the patient/family.

That's not always the case, though. Where I live, the "not for profit" hospice is more concerned with their public image than pt. care. I work for a "for profit" hospice and our administration is very concerned with pt. care.

[rnboysmom]

I don't know that I totally agree with the profit vs non-profit and that is why I did not mention it in my last post. For-profit companies will tell you that the only difference between them and NFP companies is that the NFP companies do not have to pay taxes into the community. We have 7 competing hospices in the area that I am no more impressed by the NFP agencies than the FP's. There is an older, national NFP here in the area and I interviewed with them at one time--wages were 80% of the market average here in the area and the benefits were horrible(the excuse was they were a NFP and couldn't afford to pay anymore)--this company is also known for working their nursing staff into the ground (they are leaving in droves right now) and not accepting "the expensive patients". They also have an inpatient unit that several in the community feel is "misused" to substitute for continuous care and our company has taken several of their patients that have wanted to "stay at home" for end of life care as they were informed that their patients are typically transferred to their inpatient center to die). As I have said, there are good and bad FP 's and NFP's. If I would suggest anything to look at, it would be wheter a company is locally owned or nationally owned. Nationally owned companies are paying an entire staff at the top of the chain and the money has to come form somewhere (sometimes shows up in higher nursing caseloads or poor patient suppiles). Not that all of them are bad--some locally owned companies are started by people with intentions other than patient care. The important thing is to ask the right questions and take your time selecting the right company. I would continue to insist that your best resources are speaking with current and previous employees of the company you are considering working for. I say this because once you are trained and in a position, it becomes harder to leave if you find out the company misrepresented itself as most of this that are in this profession struggle with knowing that when we leave, there will be even less people to care for the patients.

[seattledeb]

I work for a nonprofit, part of a larger religious nonprofit. The downside is that being under senior services-which is traditionally low paid, I think we are way underpaid. Hospice should be advanced home health and pay for the years of general nursing experience you come with.

But the plus is that the focus is on compassionate care, for the most part. We would not turn down a patient with financial needs, we have resources to help those in dire need of basic comforts. Our nurses are not pushed to meet financial goals. Now, they are overworked because we are too short staffed, too short staffed because we are not paid well enough to attract the experience we need, but there are measures being taken to address those things. At least I feel that there is interest in improving our org and fundamentally many good people. We are currently changing leadership and I am hoping that they hire an outsider with strong leadership skills to both corral some of the internal management issues and better advocate for us.

Also, our org has huge hiring bonuses that can always be shared, so if looking in the NW, contact me!